Immunologic function in aplastic anemia.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to C Yale.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The broad task of identifying and characterizing specific components of personality and behaviours of therapists that may be differentially helpful in the treatment of schizophrenia still remains to be addressed. This report presents data systematically collected in the course of a controlled study of the outcome of five different treatment methods in schizophrenia. Therapists seem to play a significant role in determining the outcome of the treatment of schizophrenia by drugs and by psychotherapy plus drugs. The salient therapist behaviors that seem to make a difference in outcome are yet to be identified and studied. The A-B dimension as customarily defined seems of little value for this task. The findings show a distinct need to identify cognitive and affective personality characteristics of the therapist relevant to eliciting patient cooperation, and the degree of knowledge and sophistication in the use of particular methods of treatment necessary for good results.
Explore the source record for details and available documents.
This is the second article from a study of the outcome of five different methods of treatment for schizophrenia; patients were followed up over a period of two to five years after first admission and the first release. Patients who had been originally treated in hospital with psychotherapy alone stayed longer in hospital over the follow-up period than those who had received electroconvulsive therapy (ECT), drug alone, or drug plus psychotherapy. Those who had been treated with milieu therapy also had a longer stay dated from the time of admission. Patients treated initially with drugs or ECT showed a trend toward spending less time in hospital after their release.
The extremes of drug compliance were studied in two groups of schizophrenics: 29 habitual drug-refusers who invariably discontinued medication only to be readmitted several months later, and 30 drug-complier patients who habitually came in for their refills or injections of antipsychotic medication. The drug-refusers experienced the resurgence of an ego-syntonic grandiose psychosis after they discontinued medication. The habitual compliers, in contrast, developed decompensations characterized by such dysphoric affects as depression, anxiety, virtual absence of grandiosity, and some awareness of illness. The refusal of these chronic schizophrenics to take their medication could not be attributed to social isolation, paranoid diagnosis, or secondary gain. A discriminant function analysis showed grandiosity to be the most powerful discriminating variable between the two groups. We interpret these findings to mean that some schizophrenics may prefer an ego-syntonic grandiose psychosis to a relative drug-induced normality.
The literature and the findings from the Camarillo Schizophrenia Research Project reported in this paper indicate that a satisfactory method for predicting the response of an individual schizophrenic patient to antipsychotic drugs has yet to be devised. A test dose procedure is described which offers promise of a practical approach to selecting the most appropriate drug and dosage for a particular patient and tailoring blood concentrations to the needs of the individual case. Preliminary findings indicate that the test dose procedure is feasible; that detectable changes occur after a single test dose; and that measurements made during the test dose period may be predictive of eventual outcome. These findings are, of course, only a report of a preliminary pilot experiment, subject to important caveats about small number of cases, interpretation of large numbers of correlation coefficients, and need for cross-validation. Nevertheless, they are encouraging and suggest that the test dose approach has considerable potential for further research.